Posts Tagged ‘x-ray’

A leg injury from Chile


This case has been provided by an orthopaedic  colleague from Santiago, Chile, who is studying at the University at the moment.

The series of pdf pages reads from p5 – p1 so scroll down to the end and then read the progression of this injury in reverse page order.


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AP Xray of lumbar spine

 This x-ray shows a fracture of a vertebra following a  high velocity road traffic accident. 

The lateral  view nearby shows the extent of the damage to the individual bone.

This is a good case to think about the management of major trauma in general and the risks, management and complications of this serious injury.

You can send in any answers to Dundeebones (who promises not to publish them if you are not sure they are right! ed)

Discussion on management at the end of week2 on DundeeBones.

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Left Shoulder Xray

This is the Xray of the left shoulder of a 42 year man following a fall  from a height onto his outstretched hand.

He has  a painful, immobile shoulder with  loss of the normal contour of deltoid.

What do you think the Xray shows? (there are two abnormalities to  notice here).

Remembering Prof Parkin’s lecture today it would be important to test his sensation somewhere.

After emergency management his shoulder now looks like this.

Can you say how he as been treated and what might go wrong with his shoulder during the next few days or weeks?

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OA of acromioclavicular joint

This 70 year old man is complaining  of shoulder pain when he moves his arm.

There is no  history of trauma and no limitation of shoulder movement.  It’s just painful to do!

Significantly on examination there is no  weakness of rotator cuff function and no painful arc on abduction.

This pain Xray shows a normal gleno-humeral  joint.  There is some superior migration of the humerus suggesting rotator cuff thinning.

The AC  joint shows some features of osteoarthritis.  Can you say which of these features you can identify on the X-ray?

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   Have a look at this X-ray of the lower leg and  compare it with the other X-ray of a  tibia and fibula earlier in DundeeBones.

What is different about this one?

Can you find the fractures? 

Where abouts are they in each bone?

Can you  describe the fracture pattern?

What else is wrong / unusual about the leg shown on this X-ray?  What do you think this leg would  look like if you were seeing it in A&E?

(Remind DundeeBones to post the answer next week!)

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Fracture of the week (1)

Spiral fracture

This is an antero-posterior (AP) view of the Right  tibia and fibula showing both the knee and ankle joints.

Can you  see the fracture?  Which bones are involved?

To describe the fracture site divide the bone in  to thirds and decide which  third,  proximal, mid or distal, the fracure is in.

How would  you describe the appearance of the fracture?  Does it look transverse, oblique,  spiral or comminnuted?

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